胰腺损伤伴腹内其他脏器伤的诊治分析

Analysis on diagnosis and treatment for pancreatic injury accompanied with other intra-abdominal organ injuries

目的探讨胰腺损伤伴腹内其他脏器伤患者的临床特点、诊断及治疗方法。方法回顾性分析2010年3月至2011年12月收治的24例胰腺损伤伴腹内其他脏器伤患者的资料,总结其临床特点、诊断及治疗方法。结果胰腺损伤患者有明显腹痛、腹膜刺激症状,严重者可导致失血性休克。22例闭合伤患者中2例经B超检查确诊为胰腺损伤,12例经CT检查确诊为胰腺损伤,8例术中探查确诊为胰腺损伤。Ⅰ级6例,Ⅱ级11例,Ⅲ级5例,Ⅳ级2例。其中Ⅰ级6例和Ⅱ级2例经保守治疗治愈,其余经手术治疗治愈。结论 CT检查、术中探查是诊断胰腺损伤的主要方法。根据胰腺损伤分级及其他脏器损伤情况及时选择治疗方法,可使患者获得满意的治疗效果。

Objective To investigate the clinical features,diagnosis and treatment of pancreatic injury accompanied with other intra-abdominal organ injury.Methods The data in 24 patients with pancreatic injury accompanied with intra-abdominal organ injuries treated in our hospital from March 2010 to December 2011 were retrospectively analyzed.Their clinical features,diagnosis and treatment were summarized.Results The patients with pancreatic injury had significant abdominal pain,peritoneal irritation,the severe patient resulted in hemorrhagic shock.Among 22 cases of closed injury,2 cases were diagnosed pancreatic injury by B-ultrasound,12 cases of pancreatic injury were diagnosed by CT,8 cases were diagnosed pancreatic injuryby intraoperative exploration.6 cases were the grade Ⅰ,11 cases were the grade Ⅱ,5 cases were the grade Ⅲ and 2 cases were the grade Ⅳ.In these cases,6 cases of the gradeⅠand 2 cases of the gradeⅡtook the conservative treatment.The rest cases were cured by surgical treatment.Conclusion CT examination and intraoperative exploration are the main methods for diagnosing pancreatic injury.According to classification of pancreatic injury and other intra-abdominal organ injuries,timely selecting treatment methods can obtain a satisfactory therapeutic effect.